National Healthcareer Association
MAXE · SCBC
Certified Billing & Coding Specialist
NHA
EST. 1989
A D V A N C I N G H E A LT H C A R E C A R E E R S
NHA CBCS — Certified Billing and Coding Specialist
Exam
M E D I C A L B I L L I N G & CO D I N G C E RT I F I C AT I O N
INSTITUTION National Healthcareer Association CERTIFICATION CBCS — Certified Billing & Coding
Specialist
PROGRAM Medical Billing & Coding ACADEMIC YEAR
EXAM TITLE NHA CBCS — Certified Billing and TOTAL QUESTIONS 150 Questions
Coding Specialist Exam
COURSE TITLE Certified Billing & Coding FORMAT Multiple Choice — Select the
Specialist Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question unless otherwise instructed.
▸ Billing and coding terminology, claims processing, CMS-1500 form completion, and compliance
regulations are all testable content.
▸ Insurance concepts, coding systems, and documentation standards are emphasized.
▸ Correct answers and rationales appear below each question for review purposes.
▸ All content reflects the NHA CBCS certification exam curriculum.
, SECTION I — MEDICAL BILLING, CODING &
Questions 1 – 150
COMPLIANCE
1. Which of the following actions by the billing and coding specialist prevents fraud?
A. Performing periodic audits
B. Submitting claims without review
C. Using standard coding without verification
D. Billing for services not rendered
CORRECT ANSWER A — Performing periodic audits
RATIONALE Performing periodic audits helps prevent fraud by reviewing and comparing
completed claim forms with medical documentation to ensure coding accuracy
and compliance with regulations.
2. When doing a front torso burn, which of the following percentages should be coded?
A. 18%
B. 9%
C. 36%
D. 4.5%
CORRECT ANSWER A — 18%
RATIONALE The front torso burn is coded at 18% using the Rule of Nines. The front torso
represents 18% of the total body surface area (9% for the anterior chest and 9%
for the anterior abdomen).
,3. Which of the following blocks should the billing and coding specialist complete on the
CMS-1500 claim form for procedures, services, or supplies?
A. Block 24D
B. Block 21
C. Block 33a
D. Block 17b
CORRECT ANSWER A — Block 24D
RATIONALE Block 24D on the CMS-1500 claim form is used to enter procedures, services, or
supplies using CPT or HCPCS codes. This is where the specific service codes are
reported.
4. Which of the following blocks of the CMS-1500 claim form indicates an ICD diagnosis
code?
A. Block 21
B. Block 24D
C. Block 33a
D. Block 17b
CORRECT ANSWER A — Block 21
RATIONALE Block 21 on the CMS-1500 claim form is where ICD diagnosis codes are entered.
This block contains the diagnosis codes that support the medical necessity of the
services rendered.
, 5. Which of the following national provider identifiers (NPIs) is required in Block 33a of a
CMS-1500 claim form?
A. Billing provider
B. Rendering provider
C. Referring provider
D. Supervising provider
CORRECT ANSWER A — Billing provider
RATIONALE Block 33a on the CMS-1500 claim form requires the NPI of the billing provider.
This is the provider or facility that is submitting the claim for payment.
6. Which of the following causes a claim to be suspended?
A. Services require additional information
B. Coding errors
C. Missing patient demographics
D. Incorrect provider NPI
CORRECT ANSWER A — Services require additional information
RATIONALE A claim is suspended when the payer requires additional information to process
the claim. The claim is held pending receipt of the requested information rather
than being denied outright.
MAXE · SCBC
Certified Billing & Coding Specialist
NHA
EST. 1989
A D V A N C I N G H E A LT H C A R E C A R E E R S
NHA CBCS — Certified Billing and Coding Specialist
Exam
M E D I C A L B I L L I N G & CO D I N G C E RT I F I C AT I O N
INSTITUTION National Healthcareer Association CERTIFICATION CBCS — Certified Billing & Coding
Specialist
PROGRAM Medical Billing & Coding ACADEMIC YEAR
EXAM TITLE NHA CBCS — Certified Billing and TOTAL QUESTIONS 150 Questions
Coding Specialist Exam
COURSE TITLE Certified Billing & Coding FORMAT Multiple Choice — Select the
Specialist Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question unless otherwise instructed.
▸ Billing and coding terminology, claims processing, CMS-1500 form completion, and compliance
regulations are all testable content.
▸ Insurance concepts, coding systems, and documentation standards are emphasized.
▸ Correct answers and rationales appear below each question for review purposes.
▸ All content reflects the NHA CBCS certification exam curriculum.
, SECTION I — MEDICAL BILLING, CODING &
Questions 1 – 150
COMPLIANCE
1. Which of the following actions by the billing and coding specialist prevents fraud?
A. Performing periodic audits
B. Submitting claims without review
C. Using standard coding without verification
D. Billing for services not rendered
CORRECT ANSWER A — Performing periodic audits
RATIONALE Performing periodic audits helps prevent fraud by reviewing and comparing
completed claim forms with medical documentation to ensure coding accuracy
and compliance with regulations.
2. When doing a front torso burn, which of the following percentages should be coded?
A. 18%
B. 9%
C. 36%
D. 4.5%
CORRECT ANSWER A — 18%
RATIONALE The front torso burn is coded at 18% using the Rule of Nines. The front torso
represents 18% of the total body surface area (9% for the anterior chest and 9%
for the anterior abdomen).
,3. Which of the following blocks should the billing and coding specialist complete on the
CMS-1500 claim form for procedures, services, or supplies?
A. Block 24D
B. Block 21
C. Block 33a
D. Block 17b
CORRECT ANSWER A — Block 24D
RATIONALE Block 24D on the CMS-1500 claim form is used to enter procedures, services, or
supplies using CPT or HCPCS codes. This is where the specific service codes are
reported.
4. Which of the following blocks of the CMS-1500 claim form indicates an ICD diagnosis
code?
A. Block 21
B. Block 24D
C. Block 33a
D. Block 17b
CORRECT ANSWER A — Block 21
RATIONALE Block 21 on the CMS-1500 claim form is where ICD diagnosis codes are entered.
This block contains the diagnosis codes that support the medical necessity of the
services rendered.
, 5. Which of the following national provider identifiers (NPIs) is required in Block 33a of a
CMS-1500 claim form?
A. Billing provider
B. Rendering provider
C. Referring provider
D. Supervising provider
CORRECT ANSWER A — Billing provider
RATIONALE Block 33a on the CMS-1500 claim form requires the NPI of the billing provider.
This is the provider or facility that is submitting the claim for payment.
6. Which of the following causes a claim to be suspended?
A. Services require additional information
B. Coding errors
C. Missing patient demographics
D. Incorrect provider NPI
CORRECT ANSWER A — Services require additional information
RATIONALE A claim is suspended when the payer requires additional information to process
the claim. The claim is held pending receipt of the requested information rather
than being denied outright.
